Spatial analysis of environmental sanitation and stunting incidents

Environmental factors such as sanitation and hygiene, drinking water
sources, quality of drinking water, and ownership of latrines are indirect
factors causing stunting. This study aims to analyze the distribution of
stunting and environmental sanitation factors that cause stunting in Dairi
District, North Sumatra, Indonesia. The case-control design was carried out
with 172 toddlers. The distribution pattern of stunting and the association of
patient characteristics and environmental risk factors was carried out using
the Geographic Information System. Data on healthy clean-living behavior
was collected using a questionnaire, and microbiological laboratory tests
measured water quality. The spatial analysis uses an average nearest
neighbor overlay. The association of characteristics and risk factors with the
incidence of stunting was analyzed using chi-square and logistic regression.
The average nearest neighbor analysis shows that the nearest neighbor index
is 0.19 (<1) (Z score -16.72, p-value 0.01). Regression analysis GeoDa
software (p-value 0.76). There is a relationship between clean water quality
and healthy clean-living behavior (p-value <0.05) with stunting. Family
toilets and garbage disposal facilities (p-value> 0.05) are unrelated to
stunting. The pattern of distribution of cases tended to be in clusters, and no
relationship was found between population density and the incidence of
stunting. The findings of this study provide a new understanding that health
promotion to prevent stunting does not only focus on fulfilling nutrition but
also on healthy clean-living behavior and water quality.